1669511127 NPI number — QUESTA INDEPENDENT SCHOOLS

Table of content: (NPI 1669511127)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669511127 NPI number — QUESTA INDEPENDENT SCHOOLS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
QUESTA INDEPENDENT SCHOOLS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669511127
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/11/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
07/17/2007
NPI Reactivation Date:
09/11/2007

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 440
Provider Second Line Business Mailing Address:
1 MILE NORTH HWY 522
Provider Business Mailing Address City Name:
QUESTA
Provider Business Mailing Address State Name:
NM
Provider Business Mailing Address Postal Code:
87556-0440
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
505-586-1604
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
527 SAGEBRUSH RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
QUESTA
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87556
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-586-1604
Provider Business Practice Location Address Fax Number:
505-586-2282
Provider Enumeration Date:
02/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
GALUSKY
Authorized Official First Name:
LYNN
Authorized Official Middle Name:
Authorized Official Title or Position:
SPECIAL EDUCATION DIRECTOR
Authorized Official Telephone Number:
505-586-1604

Provider Taxonomy Codes

  • Taxonomy code: 251300000X , with the licence number:  T6536 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: T6536 . This is a "SPECIAL ED. DIRECTOR" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com